Percutaneous evacuation of abdominal abscesses and fluid collections--aspiration or catheter drainage?

Ninety-three abdominal abscesses and fluid collections (pseudocysts, hematomas and bilomas) in 79 patients were treated under radiological guidance, for a total of 111 procedures (23 needle aspirations (NA) of 17 foci and 88 catheter drainages (CD) of 84 foci). In eight foci both methods were used. Catheter drainage was curative in 65% of abscesses and in 56% of pseudocysts and improved the patients' condition before surgery in another 11% or 10%, respectively. The aim of CD could not be achieved in 24% of the abscesses and in 34% of the pseudocysts. Needle aspiration showed little effect being curative in only 6% and partially beneficial in 24% as all the foci were considered. Complications occurred in 8% of CD:s and in 0% of NA:s. We suggest that radiologically guided CD of abscesses and fluid collections should be the primary therapeutic approach in all cases where this can be performed safely. The therapeutic effect of NA was poor.